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Columbia Missourian

Mental health issues afflict individuals in LGBTQ community

By Kevin Dubouis
January 6, 2013 | 6:00 a.m. CST
Halen Boykin-Rudolph poses for a portrait in his home in Fulton on Thursday. Boykin-Rudolph suffered from bulimia and anorexia nervosa as a teenager. After receiving counseling in college, he has found ways to manage his mental health disorders that have plagued him since elementary school.

COLUMBIA — When he was 16, Halen Boykin-Rudolph worked out three hours and ran 10 miles a day. Breakfast was a glass of juice and an egg. He ate nothing for lunch and only a tiny portion of whatever was served at dinner. He weighed 125 pounds and stood 5 feet 9 inches tall.

The first time he vomited after a meal, it was an accident. He'd been at the gym, and one of his friends told him he was too fat and that he’d better start working out. It was meant as a joke, but Boykin-Rudolph had always been dissatisfied with his body. He took it seriously.

Once at home, after a light dinner, he went to the bathroom to brush his teeth. His friend’s comment still haunted him.

“I put my toothbrush in too far,” he remembers.

With a mixture of revulsion and relief, he purged. The pressure was gone.

At that time, Boykin-Rudolph hadn’t yet come out to himself as bisexual. Three months later, he left for Brazil to study abroad for a year. He quickly realized that he needed the time away from home to figure out who he was. Meanwhile, purging became an automatic response when he was stressed.

Because most people are conditioned to think that eating disorders afflict only women, no one recognized the gravity of his situation. He didn’t either. It wasn't until four years later that he realized he suffered from bulimia and anorexia nervosa.

Lesbian, gay, bisexual, transgender and queer individuals in Missouri tend to experience more mental health problems related to societal stigma, discrimination and denial of their civil and human rights, according to the Missouri Foundation for Health. The report also found that gay men are three times more susceptible and lesbians almost twice as much more likely to be sexually assaulted than their heterosexual peers. It further showed that violence and victimization have long-lasting effects on the individual and the community.

Iowa State University Professor Warren Blumenfeld writes about the self-loathing of  internalized homophobia in his book, "Homophobia: How We All Pay the Price." He explained that LGBTQ individuals unconsciously assimilate negative stereotypes and attitudes of otherness, which often lead to low self-esteem, social isolation, depression and suicidal behavior.

Boykin-Rudolph, who is now a 22-year-old student at Westminster University in Fulton, now talks freely about experiences with severe mental health issues. He talked about how it has affected his life and what he has done to cope with the disorders, which began as early as elementary school.

“I have been conscious about my body image since I was very little,” he said.

His classmates would bully overweight kids, and he didn’t want that to happen to him. Standards of beauty have always haunted him. For a long time, he thought he had to be skinny, tall and muscular to be attractive. He describes an even stricter pressure in the LGBTQ community, as exemplified by models in gay publications.

During his journey in Brazil, his host family worried a lot. They saw how little he ate — the bare minimum to be polite. But they didn't broach the subject with him because they didn't know how to address it; he wasn’t their child. For his part, he was happy to be where no one was telling him what to do.

But his health was suffering. One day, he was lifting weights at a gym when he felt his head spinning. He kept lifting because he had to complete his workout to feel good about himself. Suddenly, he became light-headed and started shaking. Next thing he knew, he was lying on the floor with a weight on top of him.

“I didn’t want to hurt myself; I just wanted to look good,” said Boykin-Rudolph, realizing years later how he wronged himself. “I was terrified.”

It was the first time in his life he'd fainted. That brought the realization that he was doing something wrong.

It wasn't until later when he was a freshman in college that he began to seek help. He turned to the Internet where he found a forum that helped him to realize he had become obsessed with his body image. Still, he didn’t know the seriousness of his disorder. He began to keep a diary to monitor his eating habits, but that made him even more neurotic about his consumption.

“I obsessed about every single bite I put in to my mouth,” remembers Boykin-Rudolph recently, as he dug into a bowl of homemade chili.

He wanted to cope with the illness on his own, though he knew he was upsetting his family and friends. Fearful of appearing weak to people, he didn’t ask for counseling until his sophomore year in college.

When, for the first time, Boykin-Rudolph explained to his campus counselor how stress affected his eating habits, he was ready to be helped. The counselor knew; she had waited for him to bring it up. They both agreed that he would wait at least 30 minutes to brush his teeth after meals. He purged less and less, and he put on weight.

Abuse begets abuse

J’Lissabeth Faughn had a different experience. She's the former coordinator of MU's LGBTQ Resource Center and now runs Unity House — the University of California-Berkeley center that is connected to gender and LGBTQ studies.

During puberty, she was extremely uncomfortable with herself, but it was not the kind of discomfort that teenagers usually experience during this transitory phase. She found solace in food. In college, Faughn was still John — a man.

“If I was fat, I knew people wouldn’t look at me,” she remembers, gesturing to indicate a large stomach.

Emotional eating was also her way to deal with the physical abuse she experienced when she was a little boy. Her military father wouldn’t accept that his son played with Barbie dolls, talked about fashion or cross-dressed. His father brutalized him.

“He wanted to beat the queer out of me,” said Faughn, who describes her father dragging her out of bed by the hair.

According to the Missouri Foundation for Health, bisexual and transgender individuals report the highest average rates of physical and sexual assault.

The oppressive environment was the "normal" in which she tried to reckon with her undetermined gender identity. Today, Faughn has post-traumatic stress disorder. She feels that the psychic wounds caused by the abuse she suffered will never heal.

In college, Faughn gained excessive weight and drowned her sorrows in alcohol. Like many of her peers in the LGBTQ community, she drank heavily. The more she felt the pressure to date and have sex, the more uncomfortable she became with her gender identity and sexuality. She suffers from what the American Psychiatric Association classified as gender identity disorder.

Early in December 2012, the APA dropped gender identity disorder for the less controversial term of gender identity dysphoria. While being gay is no longer considered a mental illness, it took more than 30 years for the change to be applied to transgenderism.


When she was the coordinator of MU's LGBTQ Resource Center between 2006 and 2008, Faughn came out as a transgender female. She was finally ready to begin the transition after 28 years as a male. But nothing happened as she'd hoped. She felt discriminated against and decided Missouri wasn’t the right place to build her new identity. She had to leave.

She also needed a health care plan to cover the cost of her treatments. But as the Missouri Foundation for Health reported, LGBTQ individuals tend to be denied health care because of their sexual orientation or gender identity. In addition to homophobia, transgender individuals face problems caused by unfamiliarity with their gender.

The report showed that Missouri’s Medicaid coverage explicitly excludes transgender transition care, which includes hormone therapy and sex reassignment surgery. Without this surgery, a transgender individual cannot change the gender marker on state identification documents.

UC-Berkeley was one of the few U.S. universities to offer Faughn a post and the prized transgender-inclusive insurance. The coverage included complete transition care.

If Faughn has come a long way, she knows she is the exception to the rule. The Missouri Foundation for Health as well as the National Transgender Discrimination study reported that transgender individuals who have been harassed or assaulted experience higher rates of suicide attempts, drug and alcohol use, homelessness and HIV.

One of the reasons cited for the higher rates is Missouri’s lack of initiative on the issue of LGBTQ rights. In August 2004, 71 percent of Missouri voters ratified Amendment 2, which restricted the validity and recognition of marriage in Missouri to the union of one man and one woman. Missouri does not honor same-sex marriages from other jurisdictions.

LGBTQ couples and families are not eligible for any of the protections available to married couples.

Signs of change

State law does not address discrimination based on gender identity or sexual orientation. However, within the last seven years, Columbia, Kansas City, St. Louis City, University City, Olivette and Clayton have increased protection for members of the LGBTQ community in their city’s nondiscrimination ordinances.  

There are signs that attitudes are changing in Missouri. In October, St. Louis County voted against an amendment to ban gay marriage. Sixty-four percent of Missouri voters now support marriage or civil unions for same-sex couples, according to June poll by Public Policy Polling.

“The world is changing; people are realizing that we need to talk about taboos,” said Boykin-Rudolph. “Things are told in public and in a positive light.”

Boykin-Rudolph married Wayne Leo Boykin-Rudolph in 2010. They had a private ceremony that was attended by family and friends. It was an outdoor wedding with wine toasts and belly dancing in the warmth of a sunny July day.

They since have rented a house in both their names, but they have fewer rights when it comes to taxes or insurance. “In our mind, in our family’s mind, we are married,”  Boykin-Rudolph said. “But for the federal government, we are not.”

They are both more confident because the newer generation of Missourians is more open to a rainbow of views. They thought about going to Iowa to obtain their marriage certificate, but they belong to Missouri.

“We are both activists, so we decided to wait until Missouri recognizes gay marriage,” Boykin-Rudolph explained.

According to a study published in the American Journal of Public Health in December 2012, same-sex marriage might have mental health benefits for LGBTQ individuals. The report explained that because of a stronger perception of support and social integration, LGBTQ individuals are less likely to experience psychological distress after marriage than their nonmarried counterparts.

For now, Boykin-Rudolph imagines himself waking up one day and being able to say, "We are legally husbands."

Supervising editor is Katherine Reed.